<p>Access to basic water and sanitation services is crucial for health and well-being. This study aims to examine access to improved water sources and sanitary facilities, as well as access to integrated basic water and sanitation services. This was a cross-sectional study from the 2013 and 2018 Nigeria Demographic and Health Surveys, with a sample size of 77,896 individuals, aged 15 to 49&#xa0;years. Logistic regression analysis was performed to identify predictors of access to improved water and sanitation services. About 42% had access to both improved water sources and sanitary facilities, while 8% of the population had access to integrated basic water and sanitation services. Individuals did not exhibit a higher likelihood of accessing improved water sources and sanitary facilities, but had a reduced likelihood (AOR = 0.86, 95% CI: 0.75–0.99, <i>p</i> = 0.04) of accessing integrated basic water and sanitation services in 2018 compared to 2013. Rural residence decreased the likelihood (AOR = 0.61, 95% CI: 0.52–0.72, <i>p</i> = 0.001) of accessing improved water sources and sanitary facilities, but increased the odds (AOR = 1.24, 95% CI: 1.05–1.46, <i>p</i> = 0.01) of accessing integrated basic water and sanitation services compared to urban dwellers. Those in northeast geopolitical region had an increased odds (AOR = 2.47, 95% CI: 1.94–3.15, <i>p</i> = 0.001) of accessing integrated basic water and sanitation services compared to residents in northcentral region. In conclusion, there seems to be no recent progress in improving access to water and sanitation, with urban–rural and regional disparities.</p>